Visual Birth Planner

How it works

  • Please tick the cards below you would like to add to your visual birth plan.
  • You can remove cards at the next stage.
  • You can change the order of cards at the next stage.
  • For any customisable cards please enter your personalised text at the next stage.
  • Please create an account if you would like to save your birth plan.
Any feedback please send us an email at info@pinterandmartin.com
 

General

I’m Feeling Confident
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I’m Feeling Anxious
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I’m Feeling Scared
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I’m Feeling Excited
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First Baby
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One Previous Birth
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Two Previous Births
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Three Previous Births
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Rainbow Baby
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Ask Permission
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Special Cultural Requirement
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Special Medical Requirement
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Special Spiritual Requirement
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Special Other Requirement
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Interpreter Required
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Survivor of Abuse
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Environment

Home Birth
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Midwife-Led Unit
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Hospital Birth
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Theatre Birth
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Medical Students – OK
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Medical Students – NO
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Natural Birth
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Medical Management
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Caesarean Birth
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Hands Off
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Hands On
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Low Light Levels
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Quiet Please
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Do Not Disturb
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Labour

Gas and Air
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Hypnobirthing
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Freedom of Movement
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Massage
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Opioid Pain Relief
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TENS Machine
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Syntocinon If Necessary
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Water Birth
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Don’t Offer Me Pain Relief
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Don’t Break My Waters
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Epidural
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I Can Check My Own Cervix
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Eating and Drinking
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Routine Regular Cervical Exams
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CTG Monitoring Request
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No CTG Monitoring
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Negotiate Consent for VEs
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Cervical Examinations At Maternal Request
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No Foetal Scalp Electrode
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No Foetal Blood Sampling
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Happy for Midwife to Regularly Check Baby’s Heartbeat
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Check Baby’s Heartbeat on Maternal Request
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No Syntocinon Augmentation
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Birth

Please Encourage and Guide My Pushing
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Please Don’t Tell Me When to Push
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Midwife to Catch Baby
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Dad to Catch Baby
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Mum to Catch Baby
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Assisted Delivery if Required
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Caesarean Preferred to Assisted Delivery
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Optimal Cord Clamping
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Caesarean

Baby Born Slowly and Gently
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Catheter Privacy
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ECG Dots on Back
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IV – Left Hand
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IV – Right Hand
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Screen Lowered so We Can See the Birth
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Skin-to-Skin After Caesarean
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Talk Me Through What’s Happening
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Don’t Talk Me Through What’s Happening
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Music to Be Played
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3rd Stage

Please Don’t Wash or Wipe My Baby
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Please Wipe My Baby Down
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Calm and Dimly Lit First Hour
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Delay Weighing and Measuring
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Midwife to Cut Cord
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Partner to Cut Cord
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Mum to Cut Cord
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Active Management – Delayed
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Active Management
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Physiological Third Stage
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I Plan to Breastfeed
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I Plan to Formula Feed
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Lotus Birth
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I Want to See My Placenta
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I Want to Keep My Placenta
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I Don’t Want to See My Placenta
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Vitamin K Injection – Yes
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Vitamin K Injection – No
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Vitamin K Oral Drops
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Please Let Me Discover the Baby’s Sex
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Please Let Us Discover the Baby’s Sex
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Skin-to-Skin
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Create Plan ()